Rapid progress in modern medical technology has made it possible to sustain life and/or delay death using 'heroic' treatments. The availability of life-sustaining treatment brings several issues in end-of-life care such as 'dying with dignity' and an radical increase in health care costs. The use of Advance Directives(AD) have been widely heralded by health care providers, gerontologists, and advocacy groups as means of protecting patients' right to accept or refuse life-sustaining treatment in end-of-life care. The use of AD can not only improve patients' autonomy and quality of life but also bring efficiency in distributing health care resources. The proportion of older persons in Korean population has been increasing. Those 65 years of age or over were about 7 percent of the population. Death and dying is not limited to older persons, but it is more prevalent among them. In conjunction with an aging population and the increasing prevalence of death, the issues of death and dying will become crucial in near future in terms of 'dying with dignity', 'autonomy', and 'self-control'. This paper attempts to explode and establish the concept of advance directives (AD) based on literature review. Data sources are computer searches with the MEDLINE database. Due to the lack of prior study on AD for a Korean cases, studies abroad are reviewed. This paper suggests the need for future study on the possibility of the use of AD in Korea.
Advance Directives* ; Aging ; Surveys and Questionnaires ; Delivery of Health Care ; Health Care Costs ; Health Personnel ; Humans ; Korea ; Patient Rights ; Prevalence ; Quality of Life

This erratum is being published to revise the website address of the Korean Reference Genome Database (KRGDB) and correct two typographical errors in the article.

BACKGROUND: The purpose of this study is to evaluate the evidence for the effectiveness of different isolation policies in reducing the incidence of methicillin-resistant Staphylococcus aureus (MRSA) infection in hospital in-patients. METHODS: We prospectively evaluated the effectiveness of an isolation policy on transmission of MRSA in the 745-beds hospital. First period, all patients with MRSA (March - July 2000) were not isolated Second period, strict isolation policies were performed (August 2000 - January 2002). All patients with MRSA were isolated in separated room, hand hygiene using alcohol handrub, gowning and g1oving, apply of MRSA notice sticker, criteria in isolation remove, separated disinfection and wastement. Third period, semi strict isolation policies were performed (February 2002 - August 2005). Some patients with MRSA were isolated in separated room and others were admitted in general ward for bed shortage. Only some practices were performed in hand washing and separated disinfection in general ward. RESULTS: The rates of MRSA nosocomial infection per patients during 1st, 2nd, and 3rd surveillance were reported 0.56, 0.23, and 0.42 (P<0.05). Patient-days rate of MRSA nosocomial infection during 1st, 2nd, and 3rd surveillance were reported 0.62, 0.27, and 0.38 (P<0.05). CONCLUSION: With many different isolation policies, it was possible to reduce nosocomial infection of MRSA. In this study, strict isolation policies (2nd period) were the most effective practices in reducing MRSA infection.
Cross Infection ; Disinfection ; Hand Disinfection ; Hand Hygiene ; Humans ; Incidence ; Infection Control ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Patients' Rooms ; Prospective Studies

For determining the distribution of specific IgE and IgG-subclass antibodies and their role in allergic disorders, we measured the serum levels of specific IgG-subclass and IgE antibodies to Dermatophagoides farinae (Df) on 60 atopic children, aged between 8 to 12. All of them had positive skin test to Df, and was grouped into three: children with asthma only (group 1), with rhinitis (group 2), and with them together (group 3). Every data were compared with that of 47 nomal children. ELISA (for IgG and IgG-subclass) and RIA (for IgE) were used. The results are as following. 1) Specific IgE-antibody is significantly higher in all three allergic groups, compared with normal control group. But there was no significant difference between three allergy groups. 2) Specific IgG, IgG1, IgG2 IgG4-antibodies were higher than those in normal control group, but IgG3 was not significant. IgG1 and IgG2 were elevated particularly in patients with asthma and rhintis, but IgG4 was elevated in asthma group. 3) The linear correlation between specific IgE and IgG1-antibody was significant (r=0.286), but IgG4 did not have this correlation with IgE. In conclusion, the levels of specific IgE is essential for the diagnosis of allergies, and IgG1 and IgG4 seem to participate in allergic reactions with a different mechanism.
Antibodies ; Asthma ; Child* ; Dermatophagoides farinae* ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Humans ; Hypersensitivity ; Immunoglobulin E ; Immunoglobulin G ; Pyroglyphidae* ; Rhinitis ; Skin Tests

No abstract available.
Humans

BACKGROUND AND OBJECTIVES: To determine the level of knowledge of stroke and heart attack (HA) symptoms and risk factors of cardiovascular disease (CVD) in rural elderly people who are at risk for CVD. SUBJECTS AND METHODS: A total of 444 adults over the age of 60 living in a rural province of Korea with at least one CVD risk factor participated in this survey. RESULTS: A total of 72.5% of the participants had hypertension and 28.4% had diabetes, whereas approximately 40% exhibited over two CVD risk factors. The mean knowledge scores for HA symptoms (4.3/9) were lower than scores for stroke symptoms (5.8/9), and the mean knowledge score for risk factors was 7.3/11. Stepwise multiple regression analyses showed that old age, low level of education, and low income level were the determining factors for low knowledge levels of stroke and HA symptoms as well as CVD risk factors. A low perceived risk of stroke or HAs also predicted a low knowledge of CVD risk factors. CONCLUSION: Community-wide public campaigns are needed, which are designed to help elderly people in rural areas with low education levels and socioeconomic status at risk for CVD to improve the awareness of stroke and HA.
Adult ; Aged ; Cardiovascular Diseases ; Heart ; Humans ; Hypertension ; Korea ; Risk Factors ; Social Class ; Stroke ; Surveys and Questionnaires

Purpose: The purpose of this study was to identify factors influencing nurses’ performance of care in COVID-19 wards. Methods: The participants were 132 nurses who worked in COVID-19 wards at three hospitals, and were recruited from April 1 to May 31, 2021. Data were analyzed using descriptive statistics, t-test, ANOVA, and multiple regression analysis with SPSS/WIN 24.0 program. Results: Nursing performance was significantly and positively correlated with ethical sensitivity (r = .75, p < .001), nursing professionalism (r = .67, p < .001), and social support (r = .67, p < .001). Nursing professionalism was positively correlated with ethical sensitivity (r = .64, p < .001) and social support (r = .55, p < .001). Multiple regression analysis for nursing performance revealed that the most significant factor was ethical sensitivity (β = .47, p < .001). Ethical sensitivity, nursing professionalism, and social support explained 66.0% of total variance in nursing performance. Conclusion Ethical sensitiviy, nursing professionalism, and social support significantly influence nurses’ performace of care in COVID-19 wards. It suggests that intervention programs should be directed at improving nurses’ ethical sensitivity, bolstering social support, and enhancing nursing professionalism.

This study was prospectively conducted to investigate any relationship of nutritional status at the time of admission to length of hospital stay and mortality. All patients admitted to the Asan Medical Center between October 13 and November 12, 1997 who met the study criteria were included in the study. Patients were classified as Not-at-risk, At-risk I or At-risk II based on the levels of serum albumin and total lymphocyte count in a computerized nutrition screening program. Sixty three percent of the patients were classified as Not-at-risk Group, 29% as At-risk Group I and 8% as At-risk Group II. Significant correlation was observed between nutritional status and LOS (P<0.01) as well as mortality rate (P<0.05). The more the patient had the nutritional risk factors, the longer the LOS and the higher the mortality rate were. Further studies have to be done in order to demonstrate cost-effectiveness of medical therapy for the malnourished hospitalized patients.
Chungcheongnam-do ; Humans ; Length of Stay* ; Lymphocyte Count ; Mass Screening* ; Mortality* ; Nutritional Status* ; Prospective Studies* ; Risk Factors ; Serum Albumin

This study amis for examines the actual physical symptom and stress in caregivers of patients with cerebrovascular disease. The data were collected by a survey conducted from August to September, 1997 which included 65 caregivers of cerebrovascular disease patient in 4 hospitals located in Seoul. The caregiver's stress was measured by Choi(1992)'s instrument and the actual physical symptoms were investigated. The data were analyzed using ANOV, Scheffe test, pearson correlation coefficient and stepwise multiple regression. The results were as follows : 1. The mean number of caregiver's physical symptom was 3.5. There were significantly higher number of physical symptom in women, those of who have a religious affiliation, those of two perceive their own health status perceived s bad, and those of two perceived their patients disease condition as serious than in their counterparts. Also, the number of caregiver's physical symptom was significantly higher in caregivers whose patients have a paralysis symptom and the disease onset as spontaneous. 2. The average of caregiver's stress was 57.9. The caregiver's stress was the highest in between the ages of 50 and 59. There were also significantly higher level of stress in women, those of two perceived the disease condition of their patient as serious than in counterparts. 3. The most common caregiver's physical symptom was fatigue(87.7%). This was followed by insomnia(58.5%) and muscle (47.4%). 4. Caregiver's physical symptom was positively correlated with caregiver's stress and negatively correlated with patient's activity of daily life. 5. The most important variable affecting the caregiver's physical symptom was patient's activity of daily life which accounted for 12.7% of the total variance in stepwise multiple regression analysis. The most important variable affecting the caregiver's stress was the patient disease condition perceived by the caregiver that accounted for 12.1% of the total variance.
Caregivers* ; Female ; Humans ; Paralysis ; Seoul

PURPOSE: This descriptive study aimed to compare the perception of the acceptable foods for the neutropenic diet between nurses and patients by food type. METHODS: The participants were 225 nurses working at chemotherapy wards and 71 patients in chemotherapy treatment. Data were collected with a self-administered questionnaire from January 2 to February 24, 2012, and analyzed with SPSS 12.0 program using descriptive statistics and the chi2-test. RESULTS: Eighty-eight point eight percent of nurses and 76.1% of cancer patients thought the patients needed the neutropenic diets. The most important decisional criteria to determine dietary restriction was neutrophil count for nurses and food type for patients. The two groups showed significantly different allowance to raw fruits and raw vegetables, sterilized canned juice, fried vegetables, yogurt, uncooked tofu, salted fish, cooked fish, cooked shellfish, uncooked grain powder, jellified food, home-made bread/cookies, nuts including peanuts, instant coffee or tea and tea brewed. In general, patients were more permissive about the neutropenic diet than nurses. CONCLUSION: It is recommended to consider patients' preference as well as nurses' professional knowledge and publish standardized clinical diet guidelines for neutropenic patients with collaboration between nurses and patient representatives.
Arachis ; Edible Grain ; Coffee ; Cooperative Behavior ; Diet* ; Drug Therapy ; Fruit ; Humans ; Neutropenia ; Neutrophils ; Nuts ; Patient Advocacy ; Shellfish ; Soy Foods ; Tea ; Vegetables ; Yogurt